I'm sorry you had to go through this. I'm afraid I don't really have any answers for your questions, although I'd have to say emphasizing prevention -- helping Sam and the teachers see when he's escalating to meltdown, and deal with it before it gets too far. It did occur to me that the sheer sound of the bell ringing might have been the straw that broke the camel's back, if he's hypersensitive to noise like my son is.
http://www.autism-pdd.net/forum/forum_posts.asp?TID=17134&am p;KW=meltdown+resources - collection of meltdown resources.
http://www.fragilex.org/html/medical1.htm - article about medicating aggression, based on its source (anxiety vs. mood instability, etc).
Good luck with everything. Let us know how the return to school goes.
On Monday I received a call from school saying Sam needed to go home because he was hurting the teachers. I arrived and was debriefed.
Sam had gone to the computer lab at recess, but did not have enough time to play Runescape (his current obsession) before the bell rang. He had been given a 5 min warning and told that he would have time later inthe day to play. When the bell rang he went into an immediate meltdown, yelling and slamming his fists. His para got him out of the lab into his "quiet room" where he continued to toss chairs and bang his saucer. He would not calm down with any of the techniques that worked in the past. The para decided the quiet room was not a safe place for Sam (too many corners to hurt himself on) and got him out into the hall. Sam started running and trying to hide in the computer lab so the para got another teacher to help her block off one end.
Sam voiced all his plans to escape saying " What if I twist your fingers?, What if I run past you so fast you can't catch me? What if I run away? This went on for about an hour. Sam would charge the teachers and they would gently turn him back saying "You need to calm down, you need to be safe" Several times he hit and scratched his teachers, leaving a few bruises and scratches. When I arrived he was calm(ish) and complied with apologizing and picking up the mess he had made.
I and the para have never seen Sam quite like this. Some of the signs of increased aggression have been noted (kicking the wall or chairs) and a year ago he kicked and tried to bite his para during a similar, but less lengthy meltdown. This was different. Sam was able to voice his thoughts clearly (and loudly) and he said things I'd never heard before like "What if I run away?" He has been able to tell a friend what happened instead of ignoring it. He has been able to accept that meltdowns are a fact of life, it's not hurting others, himself or property that's important. He is willing to brainstorm alternative ideas to aggression.
His "punishment" was to be "suspended" for 2 days - a rule that aplies to all students at this school. The school wants a "graduated return" where Sam spends short periods of time at school successfully (no meltdowns) increasing with success. We are working together to see what that may look like. I do not want Sam out of school for extended periods of time and don't think this drawn- out process will work for Sam. We are tentatively shortening next week by 2 hrs a day which I am OK with as this was sucessfull Mar-June last year. I am concerned because the school does not have a clear plan and could not cite any examples where a graduated re-entry was sucessful for kids with ASD.
So, finally, my questions are:
How does your school handle children who have hurt others during a meltdown?
What are the best practices for teaching children not to hurt others during a meltdown?
How do you know when it's time to medicate a child for aggression?
I am slowly getting over my shock at Sam's meltdown. This has been harder than I thought, I guess because it's so unexpected. Sam has always been an easy-going guy that could be diverted from a meltdown in the past. I am more concerned about his getting older and closer to puberty - I wonder if hormones are at work. I noticed some *spots* on his face and he has grown soooo much recently. I also wonder if this is the "one step back" before the "two steps forward" thing ASD kids do before a major growth/maturity spurt. That acually is my gut feeling.
OK. Enough. Please share your thoughts, my head is going in circles trying to figure this one out.
mama to Sam 8 yrs PDD NOS OCD ODD PPD and Alex 2 yrs
oh man, oh man, how i understand you. I'm just not clear on one thing, did they promise he could play on runescape but then time just wouldn't allow it? If this is the case then his meltdown is completely understandable. My son had similar incidents until they decided that they would use "computer time" as a reward for good behavior. But this had to be an everyday thing...not wait until the end of the week to reward him with so much time on the computer. It had to be everyday. My son also had an awesome autistic site coach that would talk to him everyday about making the right choices, etc. When he is in a meltdown situation, no one should be talking to him during a crisis. They need to observe him while he's doing what he's doing to make sure that he doesn't injure himself and at some point, he will calm down on his own. When he is calm, that's the time they need to talk to him about what happened and what he could have done differently. This worked beautifully for my son. But as they get older, they will mature and will be more "aware" of their surroundings and who is looking at him (classmates, etc.). I hope this helps.